| NPI | 1720048572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036.124276) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C171521) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO CDR.0001023) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2024-01-17 |